@article{3077681,
    title = "Prevention of gestational diabetes mellitus in overweight or obese pregnant women: A network meta-analysis",
    author = "Chatzakis, C. and Goulis, D.G. and Mareti, E. and Eleftheriades, M. and Zavlanos, A. and Dinas, K. and Sotiriadis, A.",
    journal = "Diabetes Research and Clinical Practice",
    year = "2019",
    volume = "158",
    publisher = "Elsevier Ireland Ltd",
    issn = "0168-8227",
    doi = "10.1016/j.diabres.2019.107924",
    keywords = "metformin, cesarean section;  clinical outcome;  comparative effectiveness;  disease course;  exercise;  female;  gestational weight gain;  human;  intervention study;  maternal obesity;  meta analysis;  neonatal intensive care unit;  network meta-analysis;  pregnancy complication;  pregnancy diabetes mellitus;  pregnant woman;  prophylaxis;  randomized controlled trial (topic);  Review;  adult;  complication;  network meta-analysis;  obesity;  pregnancy;  pregnancy diabetes mellitus, Adult;  Diabetes, Gestational;  Female;  Humans;  Network Meta-Analysis;  Obesity;  Overweight;  Pregnancy",
    abstract = "Aims: Several interventions have been implemented to prevent the development of gestational diabetes mellitus (GDM) in obese pregnant women, including physical exercise programs, and administration of metformin, vitamin D and probiotics. The aim of this network meta‐analysis was to compare the efficiency of these interventions and identify the optimal. Materials: A network meta-analysis of randomized trials was performed comparing the different interventions for the development of GDM in overweight or obese women, either to each other or placebo/no intervention. A search was conducted in four electronic databases and grey literature sources. The primary outcome was the development of GDM; secondary outcomes were other complications of pregnancy. Results: The meta-analysis included 23 studies (4237 participants). None of the interventions was superior compared with placebo/no intervention for the prevention of GDM. Metformin and physical exercise were superior to placebo/no intervention for gestational weight gain (MD −1.21, 95% CI −2.14 to −0.28 and MD −0.96, 95% CI −1.69 to −0.22, respectively). Metformin was superior to placebo/no intervention for caesarean sections and admission to NICU. Conclusions: Interventions aiming to prevent the development of GDM in overweight/obese women are not effective, when applied during pregnancy. © 2019 Elsevier B.V."
}